18-week Zepbound results: 39 pounds lost in 2024

It’s time to share my 18-week Zepbound results. These four months flew by! I learned so much about how Zepbound works, how the drug affects me, and my capacity for patience as we all deal with the current Zepbound shortage.

The TLDR is that I’ve lost 39 pounds since January 1: nine pounds before I started Zepbound and 30 more pounds since starting on 2.5mg and titrating up to 5mg after three months.

I’m losing a bit more than 1.5 pounds per week. That’s a healthy rate and I’m happy with it.

Go to Lilly’s website to learn more about Zepbound (tirzepatide). Then, talk with your doctor if you want to learn more about GLP-1 weight loss medications.

By the numbers: How much I’ve lost in 2024

Zepbound results: My month-by-month progress

Month	Dose	Lbs. lost	Avg. loss per week
Month 1 Jan. 29–Feb. 26	2.5mg	7.6 lbs.	1.9 lbs.
Month 2 Feb. 26–March 25	2.5mg	8.2 lbs.	2.05 lbs.
Month 3 March 25–April 22	2.5mg	1.7 lbs.	0.425 lbs.
Month 4 April 22–May 20	5mg	7.8 lbs.	1.95 lbs.

Getting into the Zepbound groove

Here’s what it was like getting used to Zepbound over the first four months of treatment.

January: Finding a doctor and getting a Zepbound prescription

I started seriously considering Zepbound (tirzepatide) in December 2023, as soon as the U.S. Food and Drug Administration the drug to treat weight loss. (I had spent the previous year researching all GLP-1 medications.) With the holidays, a switch in primary care doctors, and onboarding with Weight Watchers Clinic, I couldn’t start treatment until January 29, 2024.

However, throughout January, I lost about 9 pounds. I did this by ramping up my…

• water intake (64 to 80+ ounces per day)
• exercise (30 minutes per day on the treadmill and/or strength training)
• protein intake (86 to 100 grams per day)

Related: How much protein should you eat per day?

I attribute most of that early loss to water weight. The first week of any focused weight loss program often results in a large drop on the scale and it’s almost always partially because of water that your body was retaining.

Starting Zepbound 2.5mg

On January 29, 2024, I took my first shot of Zepbound 2.5mg. I was nervous so my husband actually performed the injection. I picked my thigh for the first injection site. It was no big deal. I didn’t really feel a thing. For all the other shots during the last four months, I’ve injected them myself. I started with thigh injection sites but now mostly focus on injecting around my stomach. I find it the easiest spot.

When I’m ready for an injection, I take my pen out of the fridge about 30 minutes ahead of time. I also put a gel ice pack on the area I plan to inject about 20 minutes beforehand. (Wrap the ice pack in a thin towel to make this more comfortable.) The combination of chilling the injection site and room-temperature medication works for me. I continue to have no reaction at the injection site, nor do I experience any discomfort.

Note: Other people report no problem injecting medication that is cold right out of the fridge. Experiment both ways and see what works best for you.

Appetite suppression started on the day of my injection. Food noise was never a blocker for me, but I did have “diet Coke noise,” which went away immediately. It was shocking how my mind and body suddenly just let go of it. Since I wasn’t as hungry as usual, snacking was pretty much eliminated.

From Month 1, I saw positive Zepbound results, which made it easy to follow my reduced-calorie meal plan and exercise daily.

Zepbound 2.5mg side effects

Now, I know you’ve heard plenty of stories from people who’ve had terrible side effects from GLP-1 medications. I did not. The week was uneventful and I felt pretty much the same as I usually do.

Before I started taking Zepbound, my doctor instructed me to take 50mg of vitamin B6 each morning to help prevent the common side effect of nausea. I use Nature’s Craft vitamin B6 gummies, but you can also buy B6 in capsule form. To date, Zepbound has never made me feel nauseous.

In the evenings, I take 200mg of magnesium citrate to help prevent constipation. I use Nature Made gummies, but there are other brands, and it also comes in capsule form.

Sleep issues: I always have trouble getting to sleep but I did notice it took even longer on shot days. Not a terrible inconvenience, but noticeable.

Constipation: I did have mild constipation on day 3, but I started taking 2 teaspoons of Metamucil psyllium fiber supplement powder a day. That helped tremendously. When I need additional help, I’ll take 17 grams of Miralax. On Zepbound 2.5mg, I probably took Miralax once a month.

The first 3 months

I stayed on 2.5mg Zepbound for three months. I made that decision because it was working well for me in terms of weight loss and had no side effects.

Month 1 was awesome. I lost 7.6 pounds with no discomfort, so of course, I wanted to stay on 2.5mg. My doctor sent an RX for another box of 2.5mg, and my pharmacy processed it. I found out in Month 3 that they did that by mistake. Coverage should have been denied because my insurer only pays for one box of 2.5mg, 7.5mg, and 12.5mg Zepbound per year.

Related story: Drug quantity limits — Why Zepbound jumped from $35 to $550

In Month 2 on 2.5mg Zepbound, I lost another 8.2 pounds. I thought that was fantastic so, once again, I wanted to refill for the same dosage. That’s when my insurer put the hammer down and said, “Nope. If you want 2.5mg Zepbound, pay out of pocket.”

Urgh! This was right at the very beginning of the Zepbound shortage. I didn’t want to be without any medication. I went ahead and paid $550 (retail minus Lilly’s savings coupon) so I could have one more month of 2.5mg before moving up to 5mg.

Well, from the weight loss chart above, you can see that my progress took a nosedive during Month 3. My Zepbound results were much lower than in previous months, with a loss of 1.7 pounds. I was doing everything else the same as in months 1 and 2. All I can imagine is that my body was ready to move up to 5mg, and it was letting me know.

Moving up to Zepbound 5mg

I asked my doctor to send in a prescription as soon as I knew I would have to move up to Zepbound 5mg because of my insurance coverage rules. The shortage was getting worse day by day. I wanted to get that first box of 5mg before I ran out of my 2.5mg pens.

On April 22, I took my first shot of 5mg. It takes a tiny bit longer to inject than a 2.5mg pen. I always hold the pen against my skin for a full 15 seconds after I hit the purple injection button. It just makes me feel better mentally that all the medication was injected. But it doesn’t take that long. Once you hear the pen click twice, you’re all set.

Zepbound 5mg side effects

Zepbound results aren’t always positive. I did have a few side effects on 5mg, but I’d categorize them as mild.

Constipation: Occasional constipation is still an issue, but I continue my daily Metamucil regimen and take Miralax as needed (now, maybe twice per month). I also swear by this Italian bean salad recipe. It’s delicious, and it keeps me regular, so I always have single-serve packets of it in the freezer.

Sleep issues: I noticed during the first few weeks that it was harder to get to sleep on shot day. So, I recently switched from injecting in the morning to right before bed. That’s helped.

Lack of appetite: For me, 5mg feels much stronger than 2.5mg in terms of appetite suppression. There a some days when I’m not hungry at all. I’ve realized at 1:30 or 2 p.m. that I haven’t eaten yet. That has never happened to me before! LOL! On those days, I make sure to eat lean protein before anything else and mix in Isopure unflavored whey protein isolate powder in my food when possible.

Calf pain: I’m not sure if this is a side effect of Zepbound, but I wanted to mention it. Since titrating up to 5mg, I’ve had intermittent discomfort in my right calf… as if a Charley horse is about to blossom but doesn’t. I’m talking with my doctor now, and we’re trying a few things (like increased magnesium and potassium intake), so we’ll see if we can solve this issue.

Hair loss: This isn’t a side effect of the GLP-1 medication but a result of losing a lot of weight. Like all the other times I’ve lost weight in the past, I’m shedding some hair now. Not a lot, but enough that I notice it in my brush.

I take 4 tablespoons of Vital Proteins collagen peptides powder daily to combat hair loss. (I just mix the unflavored powder into my Yeti tumbler with some Crystal Light.)

Related: Should I take collagen peptides?

What these Zepbound results have done for me

In just four months, Zepbound has helped me achieve so much:

• I lost nearly 40 pounds (30 on Zep and nine in the month beforehand).
• Inflammation is way down. I have hip, knee, and ankle pain. It’s gotten much better since starting Zepbound.
• Want to take a walk? That’s no problem now. I’m walking 50 minutes a day, whereas 20 used to be challenging.
• Stairs aren’t as painful anymore. Climbing them still takes effort, but it’s getting easier every day.
• Socks are easier to put on now, and I can better cross my legs to tie my shoes.
• I don’t always need a seat belt extender on flights anymore. (I travel a lot for work.)
• My clothes fit better. In fact, I need to buy some smaller pants, shorts, and skirts.

I’m very pleased with my 18-week Zepbound results and look forward to my annual physical this summer to see if my labs have changed. I’d love to reduce the amount of cholesterol medication I take. We’ll see if that happens.